The American Academy of Pediatrics reiterated its support for the use of fluoride in caries prevention after the National Toxicology Program published a report linking higher levels of fluoride exposure with lower IQ in children.
Six notes:
1. The new NTP report concluded there is "moderate confidence" in the scientific evidence showing an association between higher levels of fluoride and lower IQ in children, the NTP said.
2. The report is mostly based on epidemiology studies in non-U.S. countries where some pregnant women, infants and children received total fluoride exposure amounts higher than 1.5 mg fluoride per liter of drinking water, which is the current safe limit recommended by the World Health Organization.
3. The AAP is concerned with the validity of the report, pointing out the report's limitations such as its study of different populations and unclear data on children's IQ levels, which the organization said can lead to unreliable conclusions.
4. Charlotte Lewis, MD, a member of the AAP Section on Oral Health, noted Aug. 23 that the NTP left out large population-based studies that found no link between fluoride and IQ.
5. The National Academies of Sciences, Engineering and Medicine also rejected two previous drafts of the NTP report, Dr. Lewis noted.
6. The AAP said it continues to recommend children use age-appropriate amounts of fluoride toothpaste and drink optimally fluoridated water to protect teeth. It also recommended dietary fluoride for children living in communities without fluoridated water and fluoride varnish applications as recommended by the U.S. Preventive Services Task Force.